How to Find the Right Therapist

Making your way through this cruel, confounding, ever-changing world is difficult. Something make you anxious this week, or any week? Lay it on me at askdaveholmes@gmail.com. I'm here to help you minimize the damage you will necessarily inflict on the world just by being alive.

So, what's your problem?

Advertisement - Continue Reading Below

Dave,

Over the last several years, life's vagaries have built up and left me feeling I'm in desperate need to talk to a therapist. How can I go about finding a solid source to speak with? One who may have specific experience with the professional and personal issues I'm dealing with?

-Eric, Chicago, IL

First of all, Eric, good on you. It takes an enormous amount of strength to start the process of psychotherapy. There is still a strange, silly stigma attached to the simple act of asking for help—especially for men, who are expected to stuff their feelings deep down inside, move through their lives like nothing ever makes them sad or anxious, and then drink whiskey and eat steaks and have heart attacks. There is a better way forward, trust me.

But know this going in: If you mention your plan to your friends and family, at least one person will put their hand on your shoulder, cock their head to one side, and say: "Oh no! What's wrong?" They mean well, but their own hangups make it difficult for them to accept one simple fact: Nothing has to be wrong for a person to decide to go to therapy. You're just trying to get better at life. Nobody asks a fit person why they're going to the gym. Nobody thinks a good band should stop rehearsing. Therapy is a workout for your emotional health. Everybody needs it, and the people who resist it the loudest, or roll their eyes, or indicate in any way that they think you're weak for getting it, are the ones who need it the most.

Nothing has to be wrong for a person to decide to go to therapy.

Advertisement - Continue Reading Below

Still, as hard as it is, you should mention it to your friends and family. You should mention it to reduce the stigma for the next guy, because stigmas are things that grow in the dark. But you should also talk about it because you definitely know someone who's in therapy right now. That person will talk to you about it, openly or privately, and you might end up with a decent recommendation. As with barbers and personal trainers, you often find someone great through word of mouth.

And as counterintuitive as it may sound, you may find that is a better way to go than through insurance. If my experience is any guide, your provider will offer you a limited number of available therapists, many will be far from where you live, and many more won't be accepting new clients. So you end up getting matched with just…whoever. You're not being assigned a parole officer here, you're hiring a therapist. You're allowed to shop around. If you're worried about money, most good therapists will operate on a "sliding scale," which means they'll charge what you're able to pay. It will be more expensive than a copay, but you'll have a much wider selection. (Plus, to get reimbursed by your insurance, your therapist has to diagnose you, and you never know when "mild depression" might come back to haunt you as a pre-existing condition.)

Here are some letters you should look for: Psy.D., Ph.D., Ed.D., LMFT (Licensed Marriage & Family Therapist), LPC (Licensed Professional Counselor), and LCSW (Licensed Clinical Social Worker). These letters mean the person has a degree in psychology or social work, and a license to practice. The people who have them typically are in therapy themselves, and many have to keep up with some form of ongoing education throughout their careers. If you don't see any of these letters, you might be talking to a life coach, which something literally anybody can call themselves.

Once you're sitting there in that therapist's office, be up front about your goals. You might have a specific need; maybe you want to talk about your relationship with drugs or alcohol, or you're in the process of coming out, or your romantic relationship is in crisis. The first person you talk to might not be right, but might steer you in the right direction. And even if the first person you talk to thinks they're right for you, trust your gut. It's a bit like dating; there's no point in trying to force it if the relationship isn't working. You should have an easy back and forth, but you want someone who asks you pointed, astute, and challenging questions. The objective isn't to make conversation, it's to make progress. You want to find someone who wants to get you out of therapy at some point. If you're just chatting, then you're paying for a friend who you will come to resent, and we all have plenty of those already.

Advertisement - Continue Reading Below

Therapy, in my experience, isn't weeping on a couch, or punching a pillow, or blaming everything on your family.

Advertisement - Continue Reading Below

Advertisement - Continue Reading Below

Therapy, in my experience, isn't weeping on a couch, or punching a pillow, or blaming everything on your family. (You may end up doing those things, FYI. None of my business.) It's revealing what you'd like to change, talking through your history, and then forming a strategy to build a better future. It's telling the stories of your life, learning to identify your thought and behavior patterns, and figuring out healthier ways to live. You'll be stunned at how obvious the things that are holding you back really are. You'll be surprised how much adult suffering has its roots in something some oblivious but well-meaning person said to you when you were 6.

As with any self-improvement endeavor, be patient with yourself. You might not get a life-changing revelation in the first month. Your life might not take a drastic turn right away. It will be more like a good shortcut you find on Waze: a few slight right turns, an aggressive left you would never have taken on your own, a shortcut through a place you haven't seen in a while, and then boom: You're right where you wanted to be.

A Part of Hearst Digital Media
Esquire participates in various affiliate marketing programs, which means we may get paid commissions on editorially chosen products purchased through our links to retailer sites.